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“This outbreak presents an incredible learning opportunity because it just crosses so many issues.... This is a moment for SIPA to stand up,” says Barrett, a leading scholar on transnational and global challenges.

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On March 30 SIPA News spoke with Scott Barrett about efforts to fight the Covid-19 coronavirus—what they say about international cooperation, what they portend for cooperation on climate change, and what the impact on society might be in the longer term.

Barrett is a leading scholar on transnational and global challenges ranging from climate change to disease eradication. His research focuses on how institutions like customary law and treaties can be used to promote international cooperation.

Barrett has advised a number of international organizations, including the United Nations, the World Bank, and the OECD. He was previously a lead author of the Intergovernmental Panel on Climate Change and a member of the World Health Organization’s Strategic Advisory Group on Malaria Eradication.

Since July 2018 Barrett has also been SIPA’s vice dean for academic affairs. He served in the same position from 2010 to 2012 after joining the SIPA faculty in 2009.

This interview has been edited and condensed for clarity.

A Framework for International Cooperation

You’ve studied international cooperation in many different contexts. What’s your assessment of the international fight to date against the coronavirus that causes Covid-19?

I think it's fair to say that the world has taken a very fragmented approach. You see a patchwork globally and you see it within the United States among the 50 states.

We should be taking a global approach. This coronavirus is a global problem, its origins are of global interest and concern, and the solutions also have to be global.

States understand that they need to cooperate to address shared problems. But the world is organized in a very different way. Power resides in nation-states—power for national defense, power for taxation, and power to enforce quarantines [to give a few examples].

Is there a specific framework for international cooperation in this area?

There is a single piece of international law that governs the relations among and obligations of states in the area of infectious diseases. It’s called the International Health Regulations and it is overseen by the World Health Organization (WHO). Every state is part of these health regulations by default; in contrast to treaties, where states have to opt in, objectors must choose not to take part in the International Health Regulations. Fortunately, every state does take part in them.

This dynamic reflects the fact that infectious diseases affect everyone, and the willingness of any one country to act for the common good depends on that country’s belief that others will also act. There cannot be exceptions, because the failure of one country to act basically threatens all the others. The International Health Regulations are interesting from a structural perspective, but generically they are but another example of where the world is better off with cooperation.

At the same time, it is pretty obvious from the experience with Covid-19 that the impulse of individual states is toward self-interest. You see this in things like travel restrictions and trade restrictions. And the conflict is even starker than that because the International Health Regulations not only impose on states obligations to report outbreaks of international concern but also to take steps to limit disruptions to travel and trade. And the WHO has recommended that nation states not take actions to limit travel and trade—and yet states have gone ahead and done this anyway.

Expectations and Obligations Under International Health Regulations

Why is that the obligation under WHO? Because limiting travel seems to make sense, at least superficially.

It’s actually an interesting question. What's the evidence that those restrictions are helpful?

The rationale for the International Health Regulations goes back to the mid-19th century, when there were cholera outbreaks in Europe. Different countries were setting different rules for quarantine, and causing a big disruption to trade. So they wanted to come up with rules that, to use today's language, were science-based and not just arbitrary.

The linkage of those two things is really important because, historically, the reason states have been reluctant to alert other countries to an outbreak is the fear that other countries would respond by restricting trade and travel—a response that would be injurious to the country that makes the declaration. So now every state has an obligation to report, and every other state has an obligation not to impose measures that can’t be justified by science.

What the WHO said early in the spread of Covid-19 was that there was no evidence that the trade and travel restrictions were actually going to be helpful and there was some evidence that they would actually be harmful. For example, restricting trade disrupts supply chains, which would make it difficult to take necessary measures to defend against the virus.

Just yesterday, I put this question to a colleague of mine at the Mailman School, Jeff Shaman, an infectious disease modeler. You can understand the impulse to restrict movement, and politicians want to be seen to be doing something, but Jeff told me that it's not clear really whether international restrictions on trade and travel actually help [except possibly in extraordinarily draconian circumstances]. I think this is one of many issues that need to be explored now by researchers, as the patchwork of responses to this crisis, including travel bans, provides the variation that researchers need to determine which interventions work, which don’t, and why.

So does the failure to follow WHO recommendations signify a failure of nations to cooperate effectively?

One of the main obligations under the International Health Regulations is for countries to report outbreaks that could pose a public-health emergency of international concern.

This requirement can be traced back to rules established in the wake the 19th-century cholera epidemics I mentioned before. Along the way, the International Health
Regulations came to include other diseases including yellow fever, typhus, smallpox, and plague.

But new diseases emerge all the time. In recent times we've had SARS and MERS, which are both coronavirus diseases. We've had BSE [bovine spongiform encephalitis], various versions of Ebola, and various versions of pandemic influenza. So it's a normal thing that there be new outbreaks of novel diseases.

In a Crisis, Resistance to Change Can Soften

You’ve said elsewhere that the requirements to report have changed since then, prompted by the SARS outbreak.

Well, when SARS erupted in China in late 2002, authorities there did not alert the international community. The WHO in February 2003 picked up some chat room discussions about strange cases of atypical pneumonia, and contacted China for more information. The next day China reported the new virus.

At that time China was under no legal obligation to report the virus. Obviously, it didn't do the right thing ethically, but it did not violate the law. And countries really came to understand as a result that the International Health Regulations were antiquated and needed to change. So after SARS they were revised.

This is an important thing for students to understand—international institutions are not perfect, but sometimes, particularly in moments of crisis, countries are willing to make changes that they wouldn't make in calmer times. In fact, countries were negotiating revisions to the International Health Regulations before the SARS outbreak, but couldn’t come to an agreement about basic things needing to be changed. And yet after SARS—because of that emergency and the things people learned at that time—countries were willing to make necessary changes. That’s when the framework evolved from a list of specific diseases to the obligation to report any disease of international concern.

What was the practical impact of that change?

With SARS the gap between the index case and reporting was a little less than three months. For Covid-19 the gap between the first case and reporting was less than one month. So you might say that the health regulations really helped.

Now, from an intellectual point of view you have to consider the counterfactual. You can’t just say that the health regulations worked; you have to compare what happened to what would have happened had they not existed. And we don't have that world.

With SARS, the WHO picked up information about the spread on February 10 [2002] and then China reported it the next day. In the case of Covid-19, China reported one day [in late December 2019] after social media reported a weird pneumonia in the Wuhan area. So one way of reading all this is that China reported [coronavirus] more quickly because of the International Health Regulations. But another way of reading it is that China only reported it because that information had leaked out through social media.

So it’s not obvious that the International Health Regulations have had a big effect.

But either way, there was a two-month head start relative to SARS.

The diseases are different, but I’d say that, generally speaking, there was definitely an improvement between SARS and Covid-19. The newspapers have emphasized the delays in China over reporting of Covid-19, with some medical people being reluctant to report so as not to upset political people, and obviously there was some of that going on. But once you allow for “normal” human error and mis-steps, the bigger picture is that the response was not too bad.

Covid-19, Climate Change, and Self-Interest

Does the handling of coronavirus, for better or worse, provide any guidance how international cooperation might be applied to other issues?

It's instructive to see how the world addresses phenomena that are very different in some respects but similar in others. We can always learn. That's what SIPA training should offer—it should help students understand these connections. What we learn about one situation can tell us something about another situation.

One thing I would say as a general matter is that self-interest, rather than international cooperation, is the main thing that’s really driving everything we’ve seen as regards Covid-19.

The trade and travel restrictions I described earlier reflect the same impulse as the social-distancing actions we each take as individuals. We have a very, very strong incentive to prevent ourselves from getting infected.

It’s not the only thing driving behavior; it doesn’t explain why doctors and nurses and all the support staff at hospitals show up at work despite the personal risk—so there's a lot of courage and bravery and sacrifice you're seeing in the world, too. But much of what we’re seeing is based on self-interest, and it happens that self-interest, relatively speaking, is helpful for the common good at the moment, because if you separate yourself from others to protect yourself you're also preventing yourself from being a part of the chain of transmission, and so helping others.

So it's a mixed picture but I think the main driver of policy and individual behavior so far, more than anything else, is self-interest.

Some people have suggested that our collective response to this challenge doesn’t bode well for future cooperation on climate change.

If the private incentive in response to Covid-19 is to protect yourself from infection by practicing social-distancing, the private incentive in response to climate change is to do very little.

For example, if I change my energy consumption, I’m one of many billions of people, so my sacrifice has a limited effect, one that rounds to zero. I'm not saying that I don't do anything or that people shouldn't do something, but the incentives for anyone to act to address climate change are pretty modest.

So the fact that you see individuals take action on coronavirus and not on climate are consistent observations. They spring from a common motivation: self-interest. This is not the only reason people act or don’t act—I don’t want to be misunderstood about that—but self-interest is a common and dominant impulse.

Does the analysis change at all if you move beyond the individual level?

I think it scales up to the level of the nation-state as well. Perhaps most importantly, the International Health Regulations and the Paris Agreement on climate change lack explicit enforcement mechansims.

The incentive of the state to protect itself from Covid-19 is powerful. If a state defends itself, it benefits greatly. Other countries will also benefit, because, if you reduce transmission within your country, you're probably going to help to reduce it globally as well. But it doesn’t matter if you care about that, because you’re going to pull out all the stops just to protect your own population. So self-interest in this case is not a bad thing.

I think where it where it can go badly is if there are measures that are taken that are advantageous domestically but disadvantageous globally, and that's certainly true with climate. But at the moment with Covid-19, every country is trying to restrict transmission within its borders and that can only be a good thing for the whole world.

So what do you see ahead, for Covid-19 or climate change or anything else?

Right now, the only means we have for limiting spread and saving lives is social-distancing. It’s very clear that testing would have helped a lot—just compare what is happening now in the United States with what happened in South Korea. It's a major failing of US policy that we weren't prepared.

I mentioned before how the earlier experience with SARS caused the International Health Regulations to be revised. Now, this is speculative, and I don't want to say that there’s strong evidence, but it looks like the countries that responded most effectively on Covid-19, including South Korea, are the same ones that paid a price for being unprepared for SARS and MERS. These countries were willing to take steps in preparation for an outbreak that we [in the U.S.] simply were not prepared to take.

And that's interesting because if you carry that over into other issues, it may mean that we have to falter somewhat before we do the right thing—that we can’t count on rational judgement to cause us to make the right decisions.

With issues like infectious diseases, the time between when you take action and when you start to see results, like waiting for the infection curve to flatten, is a matter of weeks.

With an issue like climate change, it is a matter of decades and even centuries So the timeframe is very different and I think the consequences of self-interest are more harmful for climate change than for infectious diseases.

A lasting impact, and “a moment for SIPA to stand up.”

You’ve said in some other venues that this could be an inflection point for our society.

It looks like this will be one of the biggest global events of the last 50 to 100 years, and it's going to bring about a lot of changes. We don't know today with those changes will be, but I think Covid-19 is going to have effects that will last more than a generation. And these effects will include things like trust in public institutions and maybe trust in markets. Concerns about inequality and globalization, and beliefs in government and the ability of multilateral institutions to achieve international cooperation and address shared problems—all of these things hang in the balance.

Again, we’re just in the early days of this outbreak and we’re going to have to see how things unfold, but it's fascinating to see examples from previous major pandemics. There’s the 1918-1919 influenza pandemic and before that, in 14th century Europe, there was the plague that killed about a third of the population. What's really interesting about the plague is that the loss of life made labor scarce, increasing the value of labor. Some historians think that this brought about an end to serfdom and may even have ushered in the enlightenment, the creation of universities, and totally new attitudes about such things as science and religion.

So it's possible that something bad like Covid-19, because it has such a profound effect on society, may possibly change how people see things, change what they believe, and change the institutions they are willing to support.

I don’t know if the outcome in this case will be good—I think you can’t say that at this point—but the outcome will be really important. We heard it said during the financial crisis that a crisis is also an opportunity. With so much in play right now, we could possibly make moves that would create a better world for the future.

How do you see the SIPA community reacting in the days and months ahead?

You’d rather that this crisis didn’t happen, but given that it has happened I think it’s a perfect moment for SIPA to demonstrate its value. This outbreak presents an incredible learning opportunity because it just crosses so many issues; it's about domestic politics, international relations, international law, international trade, the economy, security policy, urban policy, development; you can go on and on and on—it connects with every subject of interest to SIPA!

At SIPA we're going to do everything we can to make sure that, in this time of crisis, we provide the best possible education to our students. This means explaining why something like this happened, evaluating the responses that have been taken and saying which of these was good and which not good, and projecting into the future what the full implications of this event will be. This is a moment for SIPA to stand up.